HICAP Health Insurance Counseling and Advocacy Program

The following story is by Ann Kasper, Western Regional Coordinator.  For the past 15 years Ann has been the “heart” of the HICAP program.  As you read her story you will see why she loves what she does.

My phone rang, and when I picked it up I heard a very tragic story about a Medicare beneficiary: the caller’s wife had been in two auto accidents in 1990.  She had had surgery and therapy, but she still had back pain that had worsened over the years.  The couple had seen an ad in the desert paper that immediately caught their attention.  “Are you suffering from chronic back pain? We are doing a study of cases like yours.  Call us and see if you fit into our study group.”  It gave the number of a local surgical group.  The couple called and set up an appointment.  The office visit consisted of various tests which were covered by her insurance.  Her final pre-op visit arrived and they learned, to their dismay, that her plan had lowered the payment rate for the procedure and the surgeons involved would not do it for the new rate.  The patient would have to pay $8,000 out of pocket or the surgery was off!